Search PubMed⌕ Search

Biomedical subjects

E Koepcke

Publications and source records attributed to E Koepcke.

35 records · Page 2Linked to original sources
PubMed1977

[Isolated thrombotic omphalovasculitis with marginal insertion--a rare umbilical cord complication].

Report about 2 cases of a rare umbilical cord complication, the isolated omphalovasculitis thrombotica with marginal insertion and about their effects at the feto-placentare unity. Reference is given to an eventual embolic cause of praenatal thrombosis. It will be recommended a regular histological examination of the marginal respectively velamentous insertion for clarification of unclearly fetal deaths.

Adult↗
PubMed1976

[Ambulatory tocography].

The value of the ambulant tocography was tested in 127 cases by ambulant tocograph T 500. The average frequency of uterine contractions was in 66 normal cases 0,5/30 min. This frequency of uterine contraction was higher in a group with anamnestic risk (1,1/30 min) and in patients with tocolytic medication (2,3/30 min). Nearly term all groups tended to higher frequency of uterine contractions. The ambulant tocography is a new method to completed the diagnostic.

Ambulatory Care↗
PubMed1976

[Automatic tocography using the Cardiff infusion system under cardiotocographic control with the fetal monitor BMT 504].

Clinical results of the induction of labour by means of the Cardiff-equipment. The fetal monitor BMT-504 (VEB Kombinat Mebgerätewerk Zwönitz) has been used as cardiotocographic control unit. Labour has been induced with oxytocin (n = 38) or methyloxytocin (n = 30). 50 deliveries, which where induced by means of intravenous oxytocin infusion enables to be comparate the results. Using the automatic infusion the average induction-delivery interval was 4 hours 14 minutes, the average dosage of tocergic drugs was 2 IW oxytocin or 20 mug methyloxytocin. Using oxytocin for labour induction we found an increase in obstetric operative frequency caused by fetal distress. There where an increase in basal tone of uterine activity in this patients. Therefore we recommend methyloxytocin for the labour induction of high risk pregnancies. The safety factors, which are incorporated in the Cardiff-equipment have many advantages in obstetrical routine work, to determine fetal distress at an earlier stage. The results presented show that with this automatic infusion system labour can induced with even greater efficiency and safety. The equipment is very useful in accordance to the continuous increasing number of planned deliveries.

Female↗
PubMed1976

[Comparative studies of the value of impulse-reception methods of prenatal cardiotocography].

102 pregnant womens have been controlled by means of the various three methods of the antenatal CTG (phonocardiography, ultrasonography and indirect fetal ECG) between the 22th to 41th week. The registered time for each method was ten minutes. Between the 27th to 33th week of the pregnancy the ultrasonography gives the best results. The phonocardiography gives after the 32th week, especially after the 37th week, increasing technical unobjectionable tachograms. There was a good tachografic performans between the 22th to 27th week and after the 35th week by means of indirect fetal ECG. Between the 27th and 34th week this method refuses. The interpretation of indirect fetal ECG or phonocardiotocography, if they are possible, shows clear advantages in antenatal diagnostic of fetal condition.

Echocardiography↗
PubMed1975

[Methods of localization of chorioamnionitis and their clinical value].

121 out of 390 placentas of mostly pathological deliveries and preganancies were cases of chorioamnionitis. Histological studies have been performed under topographical respects. Several localisations (dynamic phases) of ascending infection of the secundinae are being described and their clinical relevance is being assessed. 1)"Nomal secundinae" or "physiological leucocytosis at ruptured chorionic membranes": there are but a few cases (3 to 5%) of amniotic infection syndroms or morphological signs of an aspiration of infected amniotic fluid and fetal sepsis. 2) "Isolated leucocytosis of the vessels of the umbilical cord and the chorionic plate": it is mostly caused by a fetal hypoxia; relatively seldom it is the result of an infection (about 10%). 3) "Partial phlegmon of the secundinae" (phlegmon of the chorionic membrane with spreading to the periphery of the chorionic plate): about 30% amniotic infection syndrom or infected amniotic fluid (and fetal sepsis respectively. 4) "Subtotal phlegmon of the secundinae" (phlegmon of the chorionic membrane and the chorionic plate in part, spreading to the umbilical cord): about 50% amniotic infection syndrom or infected amniotic fluid (and fetal sepsis) respectively. 5) "Total phlegmon of the secundinae" : in the majority of cases (about 65%) signs of infection damage on mother and/or fetus are visible.

Amnion↗
PubMed1975

[Possibilities in modification of the risk to the child in multiple pregnancy and labor].

A comparison of twin deliveries from 1966 to 1971 (140 = 1,23%) and from 1972 to 1974 (65 = 1,07%) indicates a decrease of the uncorrected perinatal mortality from 10,35% to 6,15% caused by early diagnosis, gestation prolonging measures, diagnosis of placental insufficiency and management of delivery. Concerning the first twin the decrease of perinatal mortality was more evident from 7,86% to 1,54% compared with the second twin from 12,86% to 10,77%. Nevertheless the following statement can be made: up to 1971 perinatal mortality was mainly a problem of prematurely born infants; it is changed now to a problem of antenatal mortality of small for date infants. Prematurely birth and mortality of twins may be well influenced by: 1. Early diagnosis. 2. Widely used hospitalisation, beginning from 28 th week of gestation. 3. Widely used cervix-cerclage and uterotocolysis. 4. Intensive antenatal care. 5. Intranatal intensive care of both infants (cardiotocography, blood gas analysis). 6. Limitation of the interval to 5 to 10 minutes. 7. Widened caesarean section indication (breech presentation, small for date infants).

Cesarean Section↗
PubMed1975

[Cardiotokography, obstetrical decission, and perinatological results].

For clinical use we divide the cardiotocographic parameters in 4 groups with the following percentages for antenatal or intranatal period. Normal criterias (antenatal: 80%; intranatal: 40%) Warn symptoms (antenatal: 5%; intranatal: 10%) Umbilico-placental circulatory disturbances (antenatal: 6%; intranatal: 45%) Signs of hypoxia (antenatal: 9%; intranatal: 5%). Variable decelerations are typically for disturbances in the umbilico-placental circulation. The clinical reasons are as well cord compressions as uterine hyperactivity or supine hypotensive syndrom. A prospective management of labor is possible only by means of CTG. The fetal death during labor is avoidable. The number of fetal micro-blood-samplings was reduced (in our hospital 10%) and the feto-maternal relationship was included. The operative frequency is the result of objective obstetrical decisions. We have before and after introduction of fetal monitoring a constant frequency of caesarean sectio of about 3%. A rise in operative frequency simultaneously with the beginning of fetal monitoring is due by a high operative activity in cases of umbilico-placental circulatory disturbances. The rate of neurological findings in newborn infants can be decreased. This result is not valid in preterm or small for date infants.

Asphyxia Neonatorum↗
PubMedDate not supplied

[Neonatal ultrasonographic cerebral findings: association with risk factor for cerebral palsy].

BACKGROUND: Is it possible to identify patients with cerebral palsy (CP) with postnatal ultrasound scan? Which risk factors are associated with an increased risk of CP?. PATIENTS AND METHODS: The data of 37 children with CP, who were sonographically investigated during the first 24 hours of life were analyzed retrospectively. The data of 21 preterm infants with gestational age </= 32 wk were compared with the data of 59 without CP. RESULTS: A tetraparesis was found in 15/21 of preterm babies </= 32 wk, a hemiparesis in 4/8 of premature infants >/= 33 wk and in 5/8 of the mature babies. The mature babies had prenatal brain atrophy or hypoxic-ischaemic cerebral lesions. Cytomegaly and encephalitis were detected in two babies. Immature babies >/= 33 wk showed prenatal porencephaly or encephalomalacia after asphyxia. Premature babies </= 32 wk had cystic periventricular leucomalacia (n=12) or cerebral haemorrhage (n=3); 3 babies had meningitis. Only two prematures </= 32 wk with mild CP had inconspicuous ultrasound scans. Factors associated with cerebral palsy were: cystic periventricular leucomalacia (OR 24,89; 95 % CI: 5,85 - 105,87), cerebral atrophy (OR 4,84; 95 % CI: 1,61 - 14,51), fetal hypoxia (CTG) - (OR 4,78; 95 % CI: 1,31 - 17,45), abruptio placentae (OR 4,32; 95 % CI: 1,16 - 16,13), anemia after birth (OR 18,13; 95 % CI: 1,97 - 166,43), abnormal neurological behavior at term (OR 14,00; 95 % CI: 3,29 - 59,55). CONCLUSION: Cerebral ultrasound scan after birth is a useful method detect for cerebral lesions in patients with CP-risks.

Abruptio Placentae↗
PubMedDate not supplied

[Cerebral hemorrhage and periventricular leucomalacia in preterm neonates after intravenous tocolysis with fenoterol: results of postnatal ultrasound examination].

BACKGROUND: This study tested whether tocolysis with beta-adrenergic agonists (Fenoterol) had an effect on the frequency of cerebral lesions in preterm neonates. PATIENTS AND METHODS: Head ultrasound scans of preterm neonates who were born after long-term (> 24 h) tocolysis were compared with scans of preterm neonates without preceding tocolysis. The gestational and neonatal data were analyzed retrospectively. RESULTS: Preterm neonates after (n = 102) and without (n = 101) tocolysis were subdivided into three groups according to their gestational age (23 - 28 wk: n = 41; 29 - 33 wk: n = 66; 34 - 36 wk: n = 96). Within these groups, no significant differences were found with respect to birth weight, rate of cesarean section, or pulmonary morbidity. Preterm babies < 28 weeks of gestation from the control group had lower Apgar scores (after 1 and 5 minutes, respectively) and arterial umbilical cord pH values. Intravenous tocolysis did not lead to an increase in pseudocystic periventricular leucomalacia (PVL) or intracerebral hemorrhage (ICH) in any of the subgroups studies. However, cerebral lesions were found in preterm neonates after tocolysis who exhibited signs of infection (29 - 33 wk: PVL n = 2; 23 - 28 wk: ICH n = 1) and in preterm neonates without tocolysis who had undergone fetal hypoxia or abruptio placentae (29 - 33 wk: PVL n = 4; antenatal terminal vein bleeding n = 1; 23 - 28 wk: PVL n = 2; terminal vein bleeding n = 5; posterior cerebral artery bleeding n = 1). When compared to preterm neonates of 34 - 36 weeks of gestation, the risk of infection was increased 4-fold in neonates of 29 - 33 weeks of gestation (odds ratio 5.43, 1.10 - 26.83) and 10-fold in neonates of 23 - 28 weeks of gestation (odds ratio 20.50, 3.65 - 115.03). Chorioamnionitis also was a more common finding in preterm neonates < 28 weeks of gestation. CONCLUSION: Preterm neonates who were born after intravenous long-term (> 24 h) tocolysis with Fenoterol do not exhibit an increase in periventricular leucomalacia or intracranial hemorrhage. The occurrence of cerebral lesions in these patients merely depends on their degree of immaturity and on the presence or absence of perinatal infection. In preterm neonates without tocolysis, brain lesions are mainly associated with hypoxic events.

Cerebral Hemorrhage↗